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High serum Antimullerian hormone levels are associated with lower live birth rates in women with polycystic ovarian syndrome undergoing assisted reproductive technology
Reproductive Biology and Endocrinology ( IF 4.4 ) Pub Date : 2020-03-10 , DOI: 10.1186/s12958-020-00581-4
Reshef Tal 1 , Charles M Seifer 2 , Moisey Khanimov 3 , David B Seifer 1, 3 , Oded Tal 4
Affiliation  

Antimullerian hormone (AMH) strongly correlates with ovarian reserve and response to controlled ovarian stimulation. Emerging data suggests that serum AMH level may also predict ART outcomes. However, AMH is characteristically elevated in PCOS women and it is unknown whether it may predict live birth outcomes in this population. This was a retrospective cohort study of 184 PCOS women (Rotterdam criteria) who underwent their first fresh IVF/ICSI cycle. Women were divided into 3 groups according to the <25th (low), 25 to 75th (average), or > 75th (high) percentile of serum AMH concentration. Cycle stimulation parameters and reproductive outcomes were compared between groups. Women in the low serum AMH group were older than those in the average or high AMH (p < 0.05), and required greater gonadotropin dose for stimulation compared to the high AMH group (p < 0.05). Women with high AMH had greater testosterone level compared to women in the low or average AMH groups. No differences were noted between groups in terms of maximal E2, oocytes retrieved and fertilization rate. However, low serum AMH women had significantly greater live birth rates (p < 0.05) and showed a trend towards greater clinical pregnancy rates compared to women in the average and high AMH groups (p = 0.09). The significant association of AMH with live birth rate remained after adjusting for age, BMI, day of transfer and number of embryos transferred. In PCOS women, elevated AMH concentrations are associated with hyperandrogenism and lower live birth rates.

中文翻译:

接受辅助生殖技术的多囊卵巢综合征妇女的高血清抗苗勒管激素水平与较低的活产率有关

抗苗勒管激素 (AMH) 与卵巢储备和对受控卵巢刺激的反应密切相关。新出现的数据表明血清 AMH 水平也可以预测 ART 结果。然而,在 PCOS 女性中 AMH 的特征是升高,尚不清楚它是否可以预测该人群的活产结果。这是一项对 184 名 PCOS 女性(鹿特丹标准)进行的回顾性队列研究,她们经历了第一次新鲜的 IVF/ICSI 周期。根据血清 AMH 浓度的 <25th(低)、25 至 75th(平均)或 >75th(高)百分位将女性分为 3 组。比较各组之间的周期刺激参数和生殖结果。低血清 AMH 组的女性比平均或高 AMH 组的女性年龄大(p < 0.05),与高 AMH 组相比,需要更大的促性腺激素剂量来刺激(p < 0.05)。与低或平均 AMH 组的女性相比,高 AMH 的女性睾酮水平更高。组间在最大 E2、取卵和受精率方面没有差异。然而,与平均和高 AMH 组的女性相比,低血清 AMH 女性的活产率显着更高(p < 0.05),并且显示出更高的临床妊娠率趋势(p = 0.09)。在调整年龄、BMI、移植天数和移植胚胎数后,AMH 与活产率的显着关联仍然存在。在 PCOS 女性中,AMH 浓度升高与雄激素过多症和较低的活产率有关。与低或平均 AMH 组的女性相比,高 AMH 的女性睾酮水平更高。组间在最大 E2、取卵和受精率方面没有差异。然而,与平均和高 AMH 组的女性相比,低血清 AMH 女性的活产率显着更高(p < 0.05),并且显示出更高的临床妊娠率趋势(p = 0.09)。在调整年龄、BMI、移植天数和移植胚胎数后,AMH 与活产率的显着关联仍然存在。在 PCOS 女性中,AMH 浓度升高与雄激素过多症和较低的活产率有关。与低或平均 AMH 组的女性相比,高 AMH 的女性睾酮水平更高。组间在最大 E2、取卵和受精率方面没有差异。然而,与平均和高 AMH 组的女性相比,低血清 AMH 女性的活产率显着更高(p < 0.05),并且显示出更高的临床妊娠率趋势(p = 0.09)。在调整年龄、BMI、移植天数和移植胚胎数后,AMH 与活产率的显着关联仍然存在。在 PCOS 女性中,AMH 浓度升高与雄激素过多症和较低的活产率有关。与平均和高 AMH 组的女性相比,低血清 AMH 女性的活产率显着更高(p < 0.05),并且显示出更高的临床妊娠率趋势(p = 0.09)。在调整年龄、BMI、移植天数和移植胚胎数后,AMH 与活产率的显着关联仍然存在。在 PCOS 女性中,AMH 浓度升高与雄激素过多症和较低的活产率有关。与平均和高 AMH 组的女性相比,低血清 AMH 女性的活产率显着更高(p < 0.05),并且显示出更高的临床妊娠率趋势(p = 0.09)。在调整年龄、BMI、移植天数和移植胚胎数后,AMH 与活产率的显着关联仍然存在。在 PCOS 女性中,AMH 浓度升高与雄激素过多症和较低的活产率有关。
更新日期:2020-04-22
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